NASH Asks HHS for More Coronavirus Grants

Private safety-net hospitals should be among high-volume Medicaid providers that receive priority consideration in the distribution of additional grants from the CARES Act, NASH has written in a letter to Health and Human Services Secretary Alex Azar and Centers for Medicare & Medicaid Services Administrator Seema Verma.

With CMS already conceding that high-volume Medicaid providers may be shortchanged in the initial distribution of funds from the $100 billion designated for hospitals and health care providers in the CARES Act, NASH asked the two officials to “…acknowledge the special needs of these hospitals and the roles they play in their communities by ensuring that they will receive much-needed assistance in the second round of grants as well.”

See NASH’s letter here.

Coronavirus Update for April 9, 2020

The following is the latest information from federal regulators as of 4:45 p.m. on Thursday, April 9.

Centers for Medicare & Medicaid Services

See an updated list of the section 1135 waivers CMS has granted to help states and health care providers respond to the COVID-19 crisis.

National Institutes of Health

The NIH has announced the launch of a clinical trial to evaluate the safety and effectiveness of hydroxychloroquine for the treatment of adults hospitalized with COVID-19.

Department of Health and Human Services

Food and Drug Administration

The FDA has published final guidance to health care professionals and investigators on the administration and study of investigational convalescent plasma collected from individuals who have recovered from COVID-19 and offers recommendations on the collection of COVID-19 convalescent plasma.

Federal Funding Opportunities for Hospitals

NASH has prepared a document that collects and presents in one place the various new federal funding opportunities for hospitals resulting from legislation addressing the COVID-19 public health emergency.  Find that document here.

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NASH Asks Congress for More COVID-19 Funding

More federal funding is needed for hospitals that serve especially high proportions of Medicaid patients and patients insured by government programs, the National Alliance of Safety-Net Hospitals has written to congressional leaders.

This is especially important now, NASH emphasized in its letter, because of new plans to use some of the $100 billion designated for hospitals and health care providers in the federal CARES Act to pay instead for care for uninsured patients who contract COVID-19.  Those payments, which NASH supports, do not address the needs for which the original $100 billion was designated:  to help hospitals – including private safety-net hospitals – with the cost of the investments they made to prepare for the expected influx of COVID-19 patients and to help them with cash flow problems arising from the loss of revenue associated with suspending elective procedures.

See NASH’s letter to congressional leaders here.

Coronavirus Update for April 8, 2020

The following is the latest information from federal regulators as of 4:15 p.m. on Wednesday, April 8.

NASH Writes to the Administration and Congress

Yesterday NASH wrote to Health and Human Services Secretary Alex Azar and Centers for Medicare & Medicaid Services administrator Seema Verma asking them to include private safety-net hospitals among the health care providers receiving funds under the second round of grants to be awarded to hospitals and health care providers under the CARES Act.

NASH also wrote yesterday to congressional leaders and key committee leaders asking them to include additional funding for hospitals and health care providers in any future COVID-19-related legislation.

Both letters are attached and will be posted on the NASH web site tomorrow

Centers for Medicare & Medicaid Services

CMS has issued a news release announcing that it has approved approximately $34 billion for providers through its Accelerated and Advance Payment Program, which was created in the CARES Act.

Department of Health and Human Services

The Department of Health and Human Services has awarded $1.3 billion to 1387 health centers to help communities detect, prevent, diagnose, and treat COVID-19.  See an interactive map that shows the centers awarded grants here.

Food and Drug Administration

Federal Emergency Management Agency

FEMA has posted a notice that it is issuing a temporary rule to allocate certain scarce or threatened materials for domestic use so that these materials may not be exported from the U.S. without the agency’s explicit approval.  These items include ventilators, personal protective equipment, and materials used to make personal protective equipment.

Federal Funding Opportunities for Hospitals

NASH has prepared a document that collects and presents in one place the various new federal funding opportunities for hospitals resulting from legislation addressing the COVID-19 public health emergency.  Find that document here.

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Coronavirus Update for April 7, 2020

The following is the latest information from federal regulators and others as of 4:15 p.m. on Tuesday, April 7.

Department of Labor

The Department of Labor has published an advisory on unemployment insurance provisions of the CARES Act.  While the advisory memo is directed to state workforce agencies, it includes detailed information about program eligibility and benefits.

Centers for Medicare & Medicaid Services

  • The Families First Coronavirus Response Act (the second major COVID-19 bill, adopted March 18) waives cost-sharing under Medicare Part B (coinsurance and deductible amounts) for Medicare patients for COVID-19 testing-related services. The latest edition of the CMS publication MLN Matters summarizes the services for which cost-sharing is waived, the types of providers to which the waived cost-sharing applies, and the coding those providers need to do to get paid.  Find the explanation here.
  • CMS has published a “Dear Clinician” letter with guidance for physicians that they may bill for e-visits for both existing and new patients; previously published guidance suggested that they could bill only for existing patients but this policy has been revised. The letter also offers guidance for how to code such telehealth visits.
  • CMS has updated its recommendations for non-emergent elective medical services and treatment. These recommendations supersede previous guidelines.
  • Earlier today CMS hosted a call to discuss CMS waivers and COVID-19 response. Find the slides used during that presentation here.
  • CMS will hold a special open door forum tomorrow, April 8, at 1:30 p.m. to discuss its actions to improve access to telehealth during the COVID-19 crisis. This one-hour call is open to everyone:  the dial-in number is 1-888-455-1397, the passcode is 3535324, and participants are asked to call in at 1:15 p.m.
  • On April 3, CMS Administrator Seema Verma, Deborah Birx, MD, White House Coronavirus Task Force, and officials from the FDA, CDC, and FEMA participated in a call on COVID-19 flexibilities. During the call physicians presented best practices from their COVID-19 experiences.

Food and Drug Administration

Centers for Disease Control and Prevention

The CDC will soon be providing $186 million in funding for additional resources for state and local jurisdictions to support their response to the COVID-19 emergency.  Funding will be for lab equipment, supplies, staff, and more for areas considered “hot zones” for COVID-19 and to enhance COVID-19 surveillance and tracking.  The news release announcing this new funding notes that “CDC will use existing networks to reach out to state and local jurisdictions to access this initial funding.”

Substance Abuse and Mental Health Services Administration

SAMHSA will fund $110 million in emergency grants to provide treatment for substance use disorders/serious mental illness during the coronavirus pandemic.  The purpose of the emergency grants is to provide crisis intervention services, mental and substance use disorder treatment, and other related recovery supports for children and adults, with funding to be provided to states, territories, and tribes.

Department of Health and Human Services

HHS has announced that it will purchase for the Strategic National Stockpile the new COVID-19 test that produces results in less than 13 minutes.  HHS will provide the tests to public health labs in every state and territory and to Indian Health Services sites.

White House

President Trump has signed a memorandum directing the Department of Defense and Department of Homeland Security to make available the National Guard to the states of Georgia, Hawaii, Indiana, Missouri, New Hampshire, New Mexico, Ohio, Rhode Island, Tennessee, and Texas and the territory of the U.S. Virgin Island to provide emergency assistance with addressing the COVID-19 crisis and for the Federal Emergency Management Agency to pay 100 percent of the cost of such assistance.

National Association of Medicaid Directors

The National Association of Medicaid Directors has written to CMS and the Office of Management and Budget (OMB) urging them “…to allow states to make retainer payments to essential Medicaid providers through Section 1115 waivers during this emergency.”  See the letter here.

Federal Funding Opportunities for Hospitals

NASH has prepared a document that collects and presents in one place the various new federal funding opportunities for hospitals resulting from legislation addressing the COVID-19 public health emergency.  Find that document here.

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Coronavirus Update for April 6, 2020

The following is the latest information from federal regulators and others as of 4:30 p.m. on Monday, April 6.

Federal Funding Opportunities for Hospitals

NASH has prepared a document that collects and presents in one place the various new federal funding opportunities for hospitals resulting from legislation addressing the COVID-19 public health emergency.  Find that document here.

Centers for Medicare & Medicaid Services

Food and Drug Administration

Occupational Safety and Health Administration

OSHA has provided interim guidance to its regional administrators and state plan designees regarding enforcement discretion to permit the extended use and reuse of respirators, and respirators that are beyond their manufacturers’ recommended shelf life during the COVID-19 emergency.

Department of Health and Human Services/Office of the Inspector General

  • The OIG has issued a policy statement regarding the application of certain administrative enforcement authorities due to the COVID-19 crisis.  This statement conveys that the OIG will not impose sanctions under anti-kickback laws related to actions by health care providers that fit under the HHS’s previous waiver of the physician self-referral provisions of the Stark law.  The OIG also has launched a new FAQ on this policy statement to provide additional information.
  • The OIG conducted a national survey of hospitals, asking them about the challenges and needs they faced.  See a summary of the survey results here and the full report here.

The White House

During Friday’s coronavirus task force press briefing, national coronavirus response coordinator Deborah Birx, M.D. explained the priority in the distribution of the new COVID-19 test that yields results in 15 minutes.

American Medical Association

The American Medical Association has issued its own “guiding principles” for the protection of current medical students and medical students:  those who are graduating early to help in the fight against COVID-19 and those who are being enlisted, while still in medical school, to participate in the direct care of COVID-19 and suspected COVID-19 patients.

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Coronavirus Update for April 3, 2020

The following is the latest information from federal regulators and others as of 4:30 p.m. on Friday, April 3.

NASH Writes to Secretary Azar

NASH has written to Health and Human Services Secretary Alex Azar asking him to distribute, as soon as possible, the $100 billion designated in the Coronavirus Aid, Relief, and Economic Security Act (the CARES Act) for hospitals and health care providers.  See NASH’s letter to Secretary Azar here.

Department of Labor

The Labor Department has published a program letter with a summary of key unemployment insurance provisions of the CARES Act and guidance regarding temporary emergency state staffing flexibility.

Federal Communications Commission

The FCC has adopted a $200 million telehealth program to support provider responding to the COVID-19 crisis.  The money will help providers purchase telecommunications, broadband connectivity, and devices necessary for providing telehealth services.  See the FCC’s news release and its formal report and order.

Centers for Disease Control and Prevention

Food and Drug Administration

Centers for Medicare & Medicaid Services

Department of Health and Human Services

  • HHS’s Office of Civil Rights has announced that it will not impose penalties for violations of certain provisions of the HIPAA privacy rule against health care providers or their business associates for the good faith uses and disclosures of protected health information by business associates for public health and health oversight activities during the COVID-19 nationwide public health emergency.  See the Office of Civil Rights announcement of this temporary policy and a pre-publication version of the formal notice of this policy that will appear shortly in the Federal Register.
  • Along with the Department of Justice, HHS has announced that the two agencies have ordered the distribution of medical supplies that in their judgment were being hoarded.  The federal government paid fair market value for 192,000 N95 masks, nearly 600,000 pairs of medical grade gloves, and 130,000 other types of masks, surgical gowns, disinfectant towels, and other supplies and is sending these supplies to the New Jersey Department of Health, the New York state Department of Health and the New York City Department of Health and Mental Hygiene.

The White House

President Trump has invoked the Defense Production Act to compel companies to undertake the manufacture of N95 respirators and ventilators.

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NASH Asks Azar to Distribute CARES Act Money Now

“Distribute as soon as possible the $100 billion designated in the [CARES] Act to assist health care providers as they deal head-on with the biggest public health crisis our country has faced in more than a century,” NASH asked Health and Human Services Secretary Alex Azar in a letter to Azar on Friday.

In the letter, the National Alliance of Safety-Net Hospitals wrote of private safety-net hospitals tackling the COVID-19 crisis that

Hospitals and other providers need these resources – and need them in a very timely manner. Hospitals invested heavily in preparations for the challenge to come and are still paying for those and continuing investments at a time when their cash flow is at an historic low because they are no longer performing elective surgery, which provides a major portion of their revenue. Thus, hospitals need this money to pay our bills, to keep the lights on and the medical supplies coming in, and to pay our courageous caregivers.

See NASH’s letter to Secretary Azar here.

Coronavirus Update: April 2, 2020

The following is the latest information from federal regulators and others as of 5:00 p.m. on Thursday, April 2.

Centers for Disease Control and Prevention

Centers for Medicare & Medicaid Services

Department of Health and Human Services

The department’s Agency for Healthcare Research and Quality will be spending $7.5 million to evaluate health system response to the COVID-19 pandemic.  The money is divided into two pools:  $5 million to evaluate innovations and challenges in rapidly expanding telehealth in response to COVID-19 and $2.5 million to active agency grant recipients and cooperative agreements.

Federal Emergency Management Agency

Food and Drug Administration

For researchers, the FDA has developed quality-controlled reference sequence data for the SARS-CoV-2 reference strain in the U.S.

Department of Labor

The Department of Labor has published a temporary rule describing the benefits under the Emergency Paid Sick Leave Act and Emergency Family and Medical Leave Expansion Act, both of which were part of the Families First Coronavirus Response Act, which was signed into law on March 18.  The law reimburses private employers with fewer than 500 employees with tax credits for the cost of providing employees with paid leave for specific reasons related to COVID-19.  The law enables employers to keep their workers on their payrolls while also ensuring that workers are not forced to choose between their paychecks and public health measures.  For more, see a Department of Labor news release describing the new temporary rule and view the rule itself here.

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Coronavirus Update: April 1, 2020

Coronavirus Update: April 1, 2020.

Medicaid DSH

The following is a revised schedule of Medicaid DSH allotment cuts.

  Before CARES After CARES
FFY 2020 $4 Billion $0
FFY 2021 $8 Billion $4 Billion
FFY 2022 $8 Billion $8 Billion
FFY 2023 $8 Billion $8 Billion
FFY 2024 $8 Billion $8 Billion
FFY 2025 $8 Billion $8 Billion
Total $44 Billion $36 Billion

 

Centers for Disease Control Prevention

The CDC has updated its guidance on responsible actions when among people who have been or may have been exposed to COVID-19.

Food and Drug Administration

The FDA has updated its reporting on the steps it is taking to accelerate the development of novel therapies for COVID-19 through its Coronavirus Treatment Acceleration Program.

The FDA has updated its list of current and resolved drug shortages and continuations.  There are currently 148 drugs on the list.  Yesterday the FDA posted information regarding shortages of hydroxychloroquine and chloroquine due to a significant surge in demand.

The FDA has issued two additional emergency use authorizations for COVID-19 diagnostics, for a total of 22 authorized tests.

State Department

The State Department has posted a message for foreign medical professionals with approved U.S. non-immigrant or immigrant visa petitions or certificates of eligibility in approved exchange visitor programs or who are already in the U.S. and would like to apply to stay.

The Joint Commission

The Joint Commission has posted a notice expressing support for permitting health care workers to bring their own standard face masks or respirators to use at work when their employers cannot “routinely provide access to protective equipment…”

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